May 2, 2014
Volume 58, Issue 18



Wisconsin’s Health System Ranks in Top Ten in Nation

Wisconsin’s health system ranked seventh best in the nation in a report by the Commonwealth Fund that assessed states on 42 indicators of health care access, quality, costs and outcomes between 2007 and 2012. Wisconsin placed in the top quartile on 18 of the performance indicators used in the 2014 report. This is the second year that the Commonwealth Report has placed Wisconsin near the top.

The performance indicators in the Commonwealth Fund’s Scorecard on State Health System Performance, 2014, evaluated care provided in a variety of settings, including hospitals, clinics, nursing homes, dental offices and home health care organizations. Wisconsin ranked in the top quartile for health care access, equity, and, prevention and treatment. The report also confirmed Wisconsin’s well-documented low hospital readmission rates.

"By focusing on the patient, our health care providers have built a continuum of care that enables the delivery of high-quality, high-value care across multiple settings in the community," said WHA President Steve Brenton. "Our physicians, nurses and support staff are committed to improving patient care and raising the level of health in their community by collaborating with other stakeholders. This report confirms that health care is a true economic development asset that contributes to the high quality of life that we enjoy in every part of the state."

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Nearly 140,000 Wisconsinites Sign Up for Private Coverage in the Exchange

The number of people in Wisconsin who selected a qualified health plan through the health insurance exchange marketplace nearly doubled, hitting 139,815 in the month of March. This latest information was released May 1 by the federal Department of Health and Human Services (HHS). The full HHS report and the appendixes showing state-level data can be found on WHA’s website at: http://www.wha.org/exchangeMedicaidEnrollment.aspx.

The data shows that in Wisconsin, 26 percent of those who selected a plan in the exchange are under the age of 35, up from 21 percent shown in previous months. The figures released by HHS also indicate which type of plan enrollees have selected, with 80 percent of those who selected a plan choosing a silver level plan or higher.

There are some limitations to the data. Only national and statewide information is available, as HHS has yet to release county-level enrollment numbers. In addition, HHS staff on a media call May 1 indicated they were not aware of any plans to release enrollment data by health plan.

As with previous reports, the latest document contains no information about how many enrollees had actually paid their premium, which is the final step that is required for actually obtaining coverage and being enrolled into a health plan. In the May 1 media call, HHS staff indicated they will commit to releasing such data when they are at a point to do that, but likely not until later this year.

Key for measuring the impact of the exchanges is how well the program has met the goals for reducing the uninsured. In Wisconsin, the exchange enrollment numbers would reflect individuals who were previously insured through HIRSP, through Medicaid and likely through other private coverage as well. The latest HHS report references various surveys aimed at estimating the number of uninsured who gained coverage since October. Reports vary widely in their estimates, however, and a recent survey by RAND indicates a potentially significant amount of transition in coverage even from one type of coverage to another. It will likely be some time before experts are able to accurately estimate the impact on the uninsured rate.

The enrollment numbers also show 81,274 people have been deemed eligible for Medicaid in Wisconsin through the exchange marketplace. This is an increase of about 13,000 people during the month of March. The Department of Health Services (DHS) said it will release a more detailed Medicaid enrollment report soon indicating the number of newly-eligible and enrolled childless adults, as well as the number of people who were disenrolled from the program on April 1 due to the changes in the income threshold for qualifying for Medicaid. DHS also indicates it continues to work with HHS to determine how many of those who were disenrolled gained coverage through the exchange marketplace.

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State Higher Ed Board Announces Applications for Physician Grant Program

The Wisconsin Higher Educational Aids Board (HEAB) has released program information for a recently-enacted primary care physician and psychiatrist shortage grant program. The program, created by 2013 Wisconsin Act 128, provides financial assistance to physicians who have graduated from a primary care or psychiatry graduate medical education training program in Wisconsin in 2014 or later and who will practice primary care or psychiatry in an underserved area of Wisconsin.

Qualifying physicians must fill out an application for the grant program prior to accepting employment. HEAB further clarified that the program is not limited only to graduates of a Wisconsin medical school, but the physician must have completed a residency training program in the state.

The law requires that HEAB provide, in total, $750,000 in financial assistance to primary care physicians and $750,000 in financial assistance to psychiatrists. The law requires the Board to provide financial assistance to at least 12 primary care physicians and 12 psychiatrists. The program in its current form will end once the $1.5 million in funds are expended.

For more information on the grant program, see the Wisconsin HEAB website: http://heab.wisconsin.gov/PrimaryCareandPsychiatryShortageGrant/hard_copy.html.

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WHA to Offer Health Law Manuals Webinar Series

WHA will be hosting a complimentary webinar series over the next few months focused on the WHA Health Law Manuals. Each webinar will showcase a specific topic covered by a respective Health Law Manual—for example, consent, mental health issues, health information, record retention and issues facing tax-exempt entities. WHA members are encouraged to register for any or all of the webinars in the series. Sign-up information, as well as more information about each of the webinars in the series, may be found at http://events.SignUp4.net/HealthLawManual. Attorneys in attendance may earn CLE credit.

Each webinar in the series will be presented by one of the following WHA corporate member law firms: Hall, Render, Killian, Heath & Lyman; Quarles & Brady; Reinhart Boerner Van Deuren; von Briesen & Roper; and Whyte Hirschboeck Dudek. These firms’ assistance was invaluable in the development of the Manuals.

The Health Law Manuals are available for WHA members to view and download at www.wha.org/healthLawManual.aspx. WHA members who would like access to the Manuals should contact webmaster@wha.org to request a username and password.

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Guest Column: Make Child Health a Priority
By Karen Ordinans, Executive Director, Children’s Health Alliance of Wisconsin

Imagine if….emergency room staff never had to treat a child with a severe toothache. Schools were filled with third-grade children who could read. Children with asthma could breathe easily. Infants and kids didn’t die from causes that could have been prevented. We strive to make this a reality for all children.

Children’s Health Alliance of Wisconsin is celebrating 20 years as Wisconsin’s voice for children’s health. We raise awareness, mobilize leaders and people, impact public health and implement programs proven to work.

Since 1994, the Alliance…

The Alliance leads programs benefiting all children, with special emphasis on those in underserved areas. We are proud to say…

While we have accomplished much, there is more to do. Our future involves expansion of our current programs and taking on new ones. The Alliance now leads the Emergency Medical Services for Children program in partnership with the Department of Health Services. We also will manage Patient at Risk, a web-based program for families to enter crucial health information about their child with special needs to inform first responders in advance of an emergency. And, the Wisconsin Asthma Coalition will promote coverage for and utilization of comprehensive asthma control services to improve the coordination of asthma care across settings.

Kids will have a bright future if we…

We are all in this together and welcome the opportunity to work with you as key partners in ensuring kids are healthy, safe and able to thrive. Visit our website at www.chawisconsin.org.

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Klasko to Keynote Rural Health Conference, June 18-20 in Elkhart Lake

Stephen Klasko, MD, president and CEO of both Thomas Jefferson University and the Thomas Jefferson Health System in Philadelphia, is the keynote speaker for the 2014 Wisconsin Rural Health Conference. He will examine the most significant changes expected in health care by 2020 and discuss strategies for rural health providers to stay a step ahead of those transformations. Previously, Klasko was the CEO of USF Health and the dean of the Morisani College of Medicine at the University of South Florida, where he implemented an entrepreneurial-academic model and developed partnerships among the colleges of medicine, nursing, public health, physical therapy and biomedical science.

The annual Wisconsin Rural Health Conference is a great way for hospital executives, leadership staff and trustees to take advantage of high-quality education, close to home, at a fraction of the travel and registration costs of out-of-state events.

Join your colleagues at The Osthoff Resort in Elkhart Lake June 18-20. The conference brochure is included in this week’s packet and online registration is available at http://events.SignUp4.net/14Rural.

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CMS Issues Proposed FY 2015 IPPS, LTCH Rule

The Centers for Medicare and Medicaid Services (CMS) released the FY2015 Inpatient Prospective Payment System and the Long Term Care Hospital PPS proposed rule on April 30. It is scheduled to appear in the May 15 edition of the Federal Register with a 60-day comment period. The entire rule is available at www.ofr.gov/(S(shrapn5vh3euajz1cq5ja3u4))/OFRUpload/OFRData/2014-10067_PI.pdf. Here are some highlights:

WHA will release a detailed summary of the rule soon along with hospital-specific impact analysis that will be available to PPS hospital members through the WHA members-only data portal.

If you haven’t signed up to access the hospital-specific reports available on the portal, sign up at http://members.wha.org.

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CMS ICD-10 Update Hints of October 1, 2015 Compliance Date

CMS released an ICD-10 update on May 1, again noting the delay that was enacted April 1, which said the Secretary may not adopt ICD-10 prior to October 1, 2015. The update states, "Accordingly, the U.S. Department of Health and Human Services expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015."

In the hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS proposed rule for fiscal year 2015 that was released by CMS on April 30, CMS solicits comments on defining Medicare-Severity Diagnosis-Related Groups (MS-DRGs) under ICD-10. CMS call for comments recognizes the changes in quality data due to the adoption of ICD-10 in the value-based purchasing program, and specifying hospital-acquired condition (HAC)/present-on-admission (POA) measures in ICD-10. The proposed rule is available at https://s3.amazonaws.com/public-inspection.federalregister.gov/2014-10067.pdf.

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